Education Week contributing writer Bryan Toporek brings you K-12 sports coverage that reaches far beyond box scores. He has written about education for Education Week and Education Week Teacher, high school sports for the Falls Church News-Press in Virginia, and is currently a Quality Editor for Bleacher Report.

Youth Football Players May Suffer Long-Term Brain Damage After One Season

While concussions tend to dominate headlines when it comes to athletes and head trauma, repeated hits to the head may be resulting in long-term brain damage for youths even if they don't suffer concussions, according to a study published online in the Journal of Neurotrauma in April.

Researchers from UT Southwestern Medical Center and the Wake Forest University School of Medicine examined data from 24 high school varsity football players who wore helmets that recorded each impact they endured during practices and games. The players went through a battery of neuropsychological tests and MRIs both before and after the season, allowing the researchers to compare their preseason baselines to their postseason results. Using diffusional kurtosis imaging (DKI), the researchers sought to determine whether a single season of high school football resulted in changes to players' brain tissues.

Even after excluding the results of players who suffered diagnosed concussions throughout the season, the study authors discovered changes in the cellular microstructure of the remaining players' brains. Those changes had a statistically significant relationship with the number of head impacts players endured throughout the season and the acceleration of each impact. They did not, however, discover a statistically significant relationship between decreases in players' neuropsychological-testing results and changes in their brain tissue.

"Our findings add to a growing body of literature demonstrating that a single season of contact sports can result in brain changes regardless of clinical findings or concussion diagnosis," said senior author Dr. Joseph Maldjian, director of the advanced neuroscience imaging research lab at UT Southwestern's Peter O'Donnell Jr. Brain Institute, in a statement.

Maldijan and his colleagues stressed the need for further research into this topic, given the study's small sample size and the possibility of a concussion going undiagnosed. However, it adds to a growing body of research suggesting youth athletes could be experiencing long-term changes to their brains even if they don't suffer concussions.

In 2011, researchers from the University of Rochester Medical Center found brain scans of high school hockey and football players sometimes showed subtle hints of injury even if the players didn't suffer concussions. A study published online in the open-access journal PLOS ONE in 2014 found some football players' brains may not fully recover from hits endured during the season even after six months of no-contact rest. That same year, a study published online in JAMA found the number of years college football players have spent playing the sport has a significant inverse relationship to the volume of a portion of their brains associated with memory.

Concussions, unsurprisingly, also may have longer-term effects even after symptoms subside. A study published in the journal Brain Pathology in 2011 found people who suffer even a single traumatic brain injury (such as concussions) could have permanent changes in their brain. In 2012, a study published in The Journal of Neuroscience found children still have changes in their brains months after suffering a concussion, even if they're symptom-free.

None of these studies definitively conclude that youth athletes shouldn't engage in contact sports, as the science is still far too nascent to make such proclamations. Youth athletes and parents should be aware, however, that concussions aren't necessarily the lone long-term concern when it comes to head impacts.

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